墨西哥快速流感诊断检测的高性能和流感疫苗的可变有效性。

High performance of rapid influenza diagnostic test and variable effectiveness of influenza vaccines in Mexico.

机构信息

Institutional Influenza Committee, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.

Department of Research in Virology and Mycology, Instituto Nacional de Enfermedades Respiratorias Ismael Cosío Villegas, Mexico City, Mexico.

出版信息

Int J Infect Dis. 2019 Dec;89:87-95. doi: 10.1016/j.ijid.2019.08.029. Epub 2019 Sep 4.

DOI:10.1016/j.ijid.2019.08.029

PMID:31493523

Abstract

OBJECTIVES

To evaluate the performance of rapid influenza diagnostic tests (RIDT) and influenza vaccines' effectiveness (VE) during an outbreak setting.

METHODS

We compared the performance of a RIDT with RT-PCR for influenza virus detection in influenza-like illness (ILI) patients enrolled during the 2016/17 season in Mexico City. Using the test-negative design, we estimated influenza VE in all participants and stratified by age, virus subtype, and vaccine type (trivalent vs quadrivalent inactivated vaccines). The protective value of some clinical variables was evaluated by regression analyses.

RESULTS

We enrolled 592 patients. RT-PCR detected 93 cases of influenza A(H1N1)pdm09, 55 of AH3N2, 141 of B, and 13 A/B virus infections. RIDT showed 90.7% sensitivity and 95.7% specificity for influenza A virus detection, and 91.5% sensitivity and 95.3% specificity for influenza B virus detection. Overall VE was 33.2% (95% CI: 3.0-54.0; p = 0.02) against any laboratory-confirmed influenza infection. VE estimates against influenza B were higher for the quadrivalent vaccine. Immunization and occupational exposure were protective factors against influenza.

CONCLUSIONS

The RIDT was useful to detect influenza cases during an outbreak setting. Effectiveness of 2016/17 influenza vaccines administered in Mexico was low but significant. Our data should be considered for future local epidemiological policies.

摘要

目的

评估在暴发期间快速流感诊断检测（RIDT）和流感疫苗效果（VE）的性能。

方法

我们比较了在 2016/17 年墨西哥城流感样疾病（ILI）患者中，RIDT 与 RT-PCR 检测流感病毒的性能。使用病例对照设计，我们估计了所有参与者的流感 VE，并按年龄、病毒亚型和疫苗类型（三价与四价灭活疫苗）进行分层。通过回归分析评估了一些临床变量的保护价值。

结果

我们共纳入 592 例患者。RT-PCR 检测到 93 例甲型 H1N1pdm09、55 例甲型 H3N2、141 例乙型和 13 例 A/B 病毒感染。RIDT 对甲型流感病毒检测的敏感性和特异性分别为 90.7%和 95.7%，对乙型流感病毒检测的敏感性和特异性分别为 91.5%和 95.3%。总的 VE 为 33.2%（95%CI：3.0-54.0；p=0.02），针对任何实验室确诊的流感感染。四价疫苗对乙型流感的估计 VE 更高。免疫接种和职业暴露是流感的保护因素。